Investigating potentially salvageable penumbra tissue in an in vivo model of transient ischemic stroke using sodium, diffusion, and perfusion magnetic resonance imaging

BMC Neuroscience

Research Article

Lothar R. Schad¹  Friedrich Wetterling²  Eva Chatzikonstantinou³  Marc Fatar³  Stephen Meairs³  Laurent Tritschler⁴  Saema Ansar⁵ 

[1] Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany;Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany;Trinity Institute of Neuroscience, University of Dublin, Dublin, Ireland;Department of Neurology, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany;Department of Neurology, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany;CESP, INSERM UMRS1178, Faculté de Pharmacie, University Paris-Sud, Université Paris-Saclay, 92296, Chatenay-Malabry, France;Department of Neurology, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany;Division of Experimental Vascular Research, Department of Clinical Sciences, Lund University, Sölvegatan 17, BMC A13, 22184, Lund, Sweden;

关键词: Diffusion;    Magnetic resonance imaging;    Perfusion;    Sodium;    Stroke;   

DOI  :  10.1186/s12868-016-0316-1

 received in 2016-08-25, accepted in 2016-11-25,  发布年份 2016

来源: Springer

【 摘 要 】

Background Diffusion magnetic resonance imaging (MRI) is the current-state-of-the-art technique to clinically investigate acute (0–24 h) ischemic stroke tissue. However, reduced apparent diffusion coefficient (ADC)—considered a marker of tissue damage—was observed to reverse spontaneously during the subacute stroke phase (24–72 h) which means that low ADC cannot be used to reflect the damaged tissue after 24 h in experimental and clinical studies. One reason for the change in ADC is that ADC values drop with cytotoxic edema (acute phase) and rise when vasogenic edema begins (subacute phase). Recently, combined 1H- and 23Na-MRI was proposed as a more accurate approach to improve delineation between reversible (penumbra) and irreversible ischemic injury (core). The aim of this study was to investigate the effects of reperfusion on the ADC and the sodium MRI signal after experimental ischemic stroke in rats in well-defined areas of different viability levels of the cerebral lesion, i.e. core and penumbra as defined via perfusion and histology. Transient middle cerebral artery occlusion was induced in male rats by using the intraluminal filament technique. MRI sodium, perfusion and diffusion measurement was recorded before reperfusion, shortly after reperfusion and 24 h after reperfusion. The animals were reperfused after 90 min of ischemia.ResultsSodium signal in core did not change before reperfusion, increased after reperfusion while sodium signal in penumbra was significantly reduced before reperfusion, but showed no changes after reperfusion compared to control. The ADC was significantly decreased in core tissue at all three time points compared to contralateral side. This decrease recovered above commonly applied viability thresholds in the core after 24 h.ConclusionsReduced sodium-MRI signal in conjunction with reduced ADC can serve as a viability marker for penumbra detection and complement hydrogen diffusion- and perfusion-MRI in order to facilitate time-independent assessment of tissue fate and cellular bioenergetics failure in stroke patients.

【 授权许可】

CC BY   
© The Author(s) 2016